1. Field of the Invention
This invention relates to a cavity retaining tool for bone surgery and a cavity retaining tool for general surgery, to be used for retaining a cavity which acts as a working space during surgery.
2. Related Art Statement
Recently, endoscopic surgery has been widely applied for the operation of tissues in a cavity of the body. Such surgery, in contrast with the open surgery whereby a wide incision is made on the body system to reach a desired site and treat it, is advantageous in that it allows the operator to insert operation tools through a smaller incision to reach a desired site in a body cavity and treat it, or that it allows a low invasive operation. It has been mentioned, however, that one of the problems inherent to endoscopic surgery is that it scarcely allows the operator to have a sufficiently wide field for operation.
Take as an example a routine operation for the removal of a herniated intervertebral disc of the vertebral column. A median incision is made dorsally to expose dorsal muscles. The dorsal muscles are cut, and are then separated with grasping forceps to expose lumbar vertebrae. Then, part of vertebral arches is removed to expose the ligamentum flavum which covers spinal roots. The ligamentum flavum is cut, the underlying dura mater is put aside to one side, and the bulged portion of the disc or the herniated disc beneath the dura mater is removed. This commonly undertaken dorsal approach consisting of making a median incision and separating dorsal muscles forcibly with forceps requires wide incision of lumbosacral muscles, separation of those muscles from bones, and long and forcible displacement of the muscles from their natural insertions during surgery. Accordingly, it has been said that the patient often develops low-back pain after surgery or suffer irreversible injuries in dorsal muscles due to forced separation of them during surgery.
To meet such situations, the specification described in U.S. Pat. No. 5,313,962 proposed a procedure for the operation of vertebrae under laparoscopic monitoring. The method consists of pulling apart the peritoneum under laparoscopic monitoring, making a cavity by inflation of a gas to push aside adjacent organs, and inserting tools into the cavity for the surgical treatment of a desired vertebral body. The specification of U.S. Pat. No. 5,439,464 proposed an alternative procedure involving a dorsal approach. The method consists of introducing a plurality of cannulae from the back of the patient into the tissues around a desired vertebra, injecting saline through one of the cannulae into the tissues, applying a pressure through the saline to produce a cavity which serves as a working space, and inserting a rigid-tube mirror and treatment tools through other cannulae into the cavity to make a surgical operation under endoscopic monitoring.
The routine operation for a herniated intervertebral disc or the so-called open surgery which consists of incising the dorsal skin, exposing dorsal muscles, and separating the muscles with grasping forceps, thereby to expose desired vertebrae, is problematic in that it gives a great damage to dorsal muscles through forced separation, and causes irreversible injuries in those dorsal muscles. In addition, the injuries inflicted on the muscles through incision itself have been said to be also serious.
The operative procedure disclosed in the specification of U.S. Pat. No. 5,313,962 involving endoscopic surgery requires a large number of treatment tools including grasping forceps for rejection of nearby organs because, with this procedure, operation proceeds while adjacent organs are being rejected by force. Thus, the work involved in the rejection becomes very complicated. In addition, because organs such as intestines and blood vessels are ready to move, and hence, if rejection force is not sufficient, they will move into the work space to disturb the visibility of the space, or suffer damages themselves in the presence of treatment tools left in the space. This is particularly true when operation proceeds ventrally towards lumbar vertebrae, because there aorta and inferior vena cava run on the frontal aspect of the lumbar vertebrae, which requires utmost care and high degree skill from the operator.
The technique described in the specification of U.S. Pat. No. 5,439,464 and involving the use of a plurality of cannulae inflict relatively less damages to dorsal muscles which may occur as a result of incision or forcible rejection, but it is far from satisfactory because it will not allow a sufficient space for vision and work.
Conventionally surgical tools having a blunt end like a swab are used to bluntly strip organs of their attachment. Such surgery tools with a blunt end have a tip wrapped with cotton, absorbs therewith liquids like blood in a body cavity, and harden over time. Hence, they must be replaced during surgery because the tip surface becomes impracticably hard.
As a remedy for such inconvenience, the specification of U.S. Pat. No. 3,935,863 introduces a technique which consists of providing detachment tools with a suction property, thereby to prevent the tip from hardening. Alternatively, the specification of U.S. Pat. No. 5,310,406 proposes a technique in which the detachment tool itself, in place of a suction tube, is allowed to absorb blood and saline accumulated in a body cavity.
True, by the techniques disclosed in the specifications of U.S. Pat. Nos. 3,935,863 and 5,310,406, it is possible to absorb blood and saline in a body cavity. These techniques, however, being dependent on the use of sponge for absorption of liquids and blood, do not allow a sufficient supply of liquids into the body cavity as desired. Thus, when the body cavity must be washed with a liquid, it is necessary to insert a forceps for liquid supply into the body cavity, which requires replacement of another forceps in use with the forceps for liquid supply.
Further, if the work for detachment leads to damages of a vessel and causes it to bleed, an electrode for hemostasis must be inserted into the body cavity.
The first object of this invention is to provide a cavity-retaining tool for bone surgery which allows the operator to make an operation on bones such as vertebrae in a less invasive manner under a sufficiently wide visual field with a visibility-aiding instrument without resorting to rejection and detachment of adjacent organs and therefore without being concerned about damages inadvertently inflicted upon those organs.
The second object of this invention is to provide a cavity-retaining tool for bone surgery which will not require a high degree skill from the operator or rather allow him to make an operation in a simplified manner.
The third object of this invention is to provide a cavity-retaining tool for general surgery which allows the operator to make an operation in a less invasive manner under a sufficiently wide field for vision and work, in spite of its requiring only minimal rejection and detachment of adjacent organs.
The fourth object of this invention is to provide a multi-functional forceps which is produced after a detachment tool for surgery has been provided with a property to expel/absorb liquid, and hence which alone is capable of bluntly detaching adjacent organs, and of expelling or absorbing liquid.
Briefly, the cavity-retaining tool for bone surgery of this invention comprises: a sheath for retaining a cavity which is inserted into the body system to form a cavity there to serve as a space for bone surgery; a channel for treatment which is attached to the cavity-retaining sheath, and serves for guiding treatment tools necessary for the treatment of bones in that work space; an observation means which is attached to the cavity-retaining sheath, and serves as a means by which to observe the treatment being undertaken in the work space for bone surgery; and a joining means which is attached to the tip of the cavity-retaining sheath, and serves for joining the tip of the cavity-retaining sheath to the surface of a bone. Further, the cavity-retaining tool for general surgery comprises a cavity-retaining means which serves for retaining a cavity in the body for operation works, and a soft cylinder member which communicates with the cavity retained by the cavity-retaining means, thereby interconnecting the cavity with the space outside the body. Still further, the endoscopic surgery system involving the use of a cavity-retaining tool comprises a cavity-retaining means to retain a cavity in the body system, and at least one port which communicates with the cavity, so that interconnection between the port and the cavity is established within the body.